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World Health Organization: Use of new child growth standards to assess how infant malnutrition relates to breastfeeding and mortality

January, 2010

Malnutrition contributes to about one-third of the 9.7 million child deaths that occur each year. Recently, the World Health Organization (WHO) introduced new child growth standards for use in deriving indicators of nutritional status, such as stunting, wasting and underweight. These standards are based on the growth of infants from six different regions of the world who were fed according to WHO and United Nations Children’s Fund (UNICEF) feeding recommendations, had a non-smoking mother, had access to primary health care and did not have any serious constraints on health during infancy or early childhood. It is recommended that these new growth standards replace the previously recommended international growth reference devised by the National Center for Health Statistics (NCHS) in the United States.

The prevalence of malnutrition estimated using WHO standards is expected to differ from that based on the NCHS growth reference because there are differences in median weight-for-age, height-for-age and weight-for-height between the two. Recent studies have investigated the direction and magnitude of these differences. In children aged 6–59 months, the prevalence of stunting (i.e. low height-for-age) and wasting (i.e. low weight-for-height) were higher when WHO standards were used but that of underweight (i.e. low weight-for-age) was lower. In the first half of infancy (i.e. the period from birth up to the end of the 6th month), the prevalence of stunting, wasting and underweight has been reported to be higher with WHO growth standards. It is important that the magnitude of these apparent changes in the prevalence of malnutrition are investigated in different settings in order to gain a better understanding of their implications, particularly for child health and nutrition programmes whose progress is monitored through large household surveys.

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